Pediatric and Juvenile Strabismus Surgery Under General Anesthesia: Functional Outcomes and Safety.

Background/

Objectives

The aim of this paper was to evaluate the safety of surgical intervention using anesthesia and ophthalmological parameters in pediatric strabismus patients. The design involved retrospective case series.

Methods

The setting was the Department of Ophthalmology, Medical University Vienna, Austria.

Participants

In total, 208 children aged 0-18 years who underwent strabismus surgery due to exotropia or esotropia between 2013 and 2020 were included. Main outcomes and measures: Information regarding the duration of surgery, intra- and postoperative complications, the postoperative angle of deviation (AoD), and functional outcomes (visual acuity, stereovision) were analyzed.

Results

The mean age at the time of surgery was 6.0 ± 4.1 years (range 0.6-18.0). The mean anesthesia time among all patients was 75.9 ± 19.3 min. The mean surgery and anesthesia time did not differ between the age groups. Longer anesthesia durations and surgery durations did not have a significant effect on the occurrence of intraoperation complications (p = 0.610 and p = 0.190, respectively). Intraoperative complications were recorded in 53% (most frequent triggering of oculocardiac reflex (OCR)) of the patients, and postoperative complications in 22% (the most frequent were postoperative nausea and vomiting and pain). An OCR was triggered more often in children older than 6 years than in younger children (p = 0.016). The mean angle of deviation was significantly reduced from preoperative to postoperative measurements. Preoperative stereovision tests were positive in 35% of the patients and increased to over 80% postoperatively.

Conclusions

Strabismus surgery performed under general anesthesia in children aged 0 to 18 years is safe with regard to both surgical and anesthetic complications. A significant decrease in the angle of deviation and high rate of stereovision could be achieved with a low rate of re-treatments. However, the retrospective design, absence of standardized documentation, and limited sample size may affect the consistency and comparability of this study's findings.